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Odonkor MN, Dada OE, Rincon-Torroella J, Pahwa B, Balogun JA, Ukachukwu AEK, Fuller AT, Huang J, Groves M, Badejo OA, Abu-Bonsrah N. Perceived Barriers to Pursuing a Career in Neurosurgery in Nigeria: A Cross-Sectional Survey of Nigerian Medical Students and Unspecialized Physicians. World Neurosurg 2024; 185:e57-e74. [PMID: 38741330 DOI: 10.1016/j.wneu.2023.11.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 05/16/2024]
Abstract
BACKGROUND Nigeria has an inadequate number of neurosurgeons to meet the population's demand for neurosurgical care. Furthermore, few Nigerian neurosurgeons are female. This study sought to evaluate perceived barriers to pursuing neurosurgery among Nigerian trainees. METHODS A 60-question survey was distributed electronically to medical students at the College of Medicine, University of Ibadan, and unspecialized intern physicians at the University College Hospital, Ibadan, Nigeria. Participation was voluntary. RESULTS One hundred fifty-seven respondents participated in the survey. A greater proportion of males indicated an interest in neurosurgery than females (40% vs. 18%, P = 0.010). Over 75% of respondents identified decreased family and personal time, long work hours, and limited access to maternity or paternity leave as potential barriers to neurosurgery, with no differences by gender. Respondents overall saw being female and low-income as disadvantageous to pursuing neurosurgery in Nigeria. Although they universally viewed research as important in neurosurgery, 59% of respondents reported inadequate access to research opportunities; this did not vary by gender. However, 65% of female respondents reported that having a female neurosurgery mentor would increase their interest in neurosurgery (vs. 37% of males, P = 0.001). CONCLUSIONS Nigerian medical trainees perceived the time commitment of neurosurgery as a major barrier to pursuing the specialty. Regardless of gender, they also reported low exposure to neurosurgery and inadequate access to research and mentorship opportunities. However, we found that enhanced female representation among neurosurgery mentors and improved work-life balance could increase interest in neurosurgery and help expand Nigeria's neurosurgical workforce.
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Affiliation(s)
- Michelle N Odonkor
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | | | | | - Bhavya Pahwa
- University College of Medical Sciences, New Delhi, Delhi, India
| | - James A Balogun
- College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; Department of Neurological Surgery, University College Hospital, Ibadan, Oyo, Nigeria
| | - Alvan-Emeka K Ukachukwu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Hospital, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Hospital, Durham, North Carolina, USA
| | - Judy Huang
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Mari Groves
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Oluwakemi A Badejo
- College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria; Department of Neurological Surgery, University College Hospital, Ibadan, Oyo, Nigeria
| | - Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
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Mangham W, Parikh KA, Motiwala M, Gienapp AJ, Roach J, Barats M, Lillard J, Khan N, Arthur A, Michael LM. A Scoping Review of Professionalism in Neurosurgery. Neurosurgery 2024; 94:435-443. [PMID: 37819083 DOI: 10.1227/neu.0000000000002711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/10/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Accreditation Council for Graduate Medical Education's Milestones provides a foundation for professionalism in residency training. Specific professionalism concepts from neurosurgery could augment and expand milestones for the specialty. We reviewed the current literature and identified professionalism concepts within the context of neurosurgical practice and training. METHODS We used a scoping review methodology to search PubMed/MEDLINE and Scopus and identify English-language articles with the search terms "professionalism" and "neurosurgery." We excluded articles that were not in English, not relevant to professionalism within neurosurgery, or could not be accessed. Non-peer-reviewed and qualitative publications, such as commentaries, were included in the review. RESULTS A total of 193 articles were included in the review. We identified 6 professionalism themes among these results: professional identity (n = 53), burnout and wellness (n = 51), professional development (n = 34), ethics and conflicts of interest (n = 27), diversity and gender (n = 19), and misconduct (n = 9). CONCLUSION These 6 concepts illustrate concerns that neurosurgeons have concerning professionalism. Diversity and gender, professional identity, and misconduct are not specifically addressed in the Accreditation Council for Graduate Medical Education's Milestones. This review could be used to aid the development of organizational policy statements on professionalism.
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Affiliation(s)
- William Mangham
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Kara A Parikh
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Mustafa Motiwala
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Andrew J Gienapp
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis , Tennessee , USA
| | - Jordan Roach
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Michael Barats
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Jock Lillard
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Nickalus Khan
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - Adam Arthur
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - L Madison Michael
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
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Sindi MA, Almadani MH, Sindi MA, Alturaif AH, Altahini KW, Aljohani N, Zaher SJ, Alhibshi AH, Bokhary NH, Alfaidi F, Alfaidi K, Al-Sebaei M, Alshehri MR. Factors Influencing Specialty and Training Center Choices Among Saudi Medical Residents. Cureus 2023; 15:e48844. [PMID: 38106708 PMCID: PMC10723105 DOI: 10.7759/cureus.48844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
AIM This cross-sectional study aims to identify and quantify the factors influencing Saudi medical residents in selecting their desired specialty and primary training center, while examining the associations between these factors. METHODS The study received approval from an institutional ethical committee at King Abdulaziz University. An electronic questionnaire was designed and validated via content, face validity, and the Content Validity Index. The sample size was calculated based on a 95% CI and a 5% margin of error. The study targeted all current residents in the current Saudi Specialty Certificate Programs. Descriptive statistics summarized demographic characteristics, training-related information, and factors influencing the selection of a specialty and training center. Fisher's exact test and Chi-square tests were employed for data analysis. RESULTS A total of 387 respondents completed the survey, with a 32.3% response rate. The majority of respondents were male (n = 232, 59.9%), and the majority were also married (n = 67.2%), with internal medicine (n = 92, 23.8%) and family medicine (n = 74, 19.1%) being the most prevalent specialties. Notably, 89.4% (n = 346) reported matching into their first-choice specialty, and 67.2% (n = 260) into their first-choice training center. Furthermore, 90.2% (n = 349) had prior training (elective/internship) in their chosen specialty, and 63% (n = 244) had previous training (elective/internship) at their primary training center. Prior exposure to both specialty and center significantly resulted in them being the resident's top choice (p < 0.01). Multiple factors influencing the choice of either the specialty or the center were found to have statistically significant associations with the gender, specialty, residency level, sector of the training center, and timing of the specialty decision (p < 0.05). CONCLUSION This study reveals the substantial influence of early experiences on Saudi medical residents' specialty and training center choices. It also uncovers gender disparities and variations in the influence of specialty-related factors. Future research with larger and more diverse samples is recommended to gain a deeper understanding of the multifactorial decision-making processes, enabling the development of strategies to better meet the evolving needs and preferences of healthcare professionals in Saudi Arabia.
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Affiliation(s)
- Mohammed A Sindi
- General Dentistry, King Abdulaziz University Hospital, Jeddah, SAU
| | - Mahmoud H Almadani
- Department of Neurology, King Abdulaziz University Hospital, Jeddah, SAU
| | - Marah A Sindi
- Department of Family Medicine, Ministry of Health, Dammam, SAU
| | - Ali H Alturaif
- Department of Physical Medicine and Rehabilitation, Prince Sultan Military Medical City, Riyadh, SAU
| | | | - Naif Aljohani
- Department of Family Medicine, Ministry of Health, Makkah, SAU
| | - Sary J Zaher
- Department of Family Medicine, Ministry of Health, Jeddah, SAU
| | - Ahmad H Alhibshi
- Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Nidal H Bokhary
- Department of Emergency Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Faisal Alfaidi
- Department of Radiology, King Abdulaziz Medical City Jeddah, Jeddah, SAU
| | - Khalid Alfaidi
- Department of Urology, King Abdullah Medical Complex, Jeddah, SAU
| | - Maisa Al-Sebaei
- Oral and Maxillofacial Surgery, King Abdulaziz University Hospital, Jeddah, SAU
| | - Maha R Alshehri
- Pediatric Dentistry, King Abdulaziz University Hospital, Jeddah, SAU
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Lawson McLean A, Lawson McLean AC. Resilience and recovery in neurosurgical residency: Unpacking lessons from video game mechanics. BRAIN & SPINE 2023; 3:101793. [PMID: 38020986 PMCID: PMC10668065 DOI: 10.1016/j.bas.2023.101793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/25/2023] [Accepted: 08/11/2023] [Indexed: 12/01/2023]
Abstract
Introduction Neurosurgical residency is a challenging journey demanding cognitive acuity and resilience, mirrored strikingly in the dynamics of video gaming. Gaming concepts of Down-But-Not-Out (DBNO), Heal-over-Time (HoT), and Damage-over-Time (DoT) can serve as compelling analogues to elements of neurosurgical training. Material and methods An innovative, cross-disciplinary methodology was implemented, blending elements of autoethnography, personal reflective narrative, and comprehensive literary review. The cornerstone of this approach was an experiential reflective analysis, where two neurosurgical residents critically examined the parallels between their residency experiences and video game mechanics, thereby applying a lens of heuristic introspection to their professional journey. Complementing this, a comprehensive narrative synthesis of existing literature on resilience, wellness, and stress in neurosurgical residency training was conducted. Results The DBNO concept parallels the resilience demonstrated by neurosurgical residents, emphasizing the importance of a supportive network. The HoT concept, analogous to wellness practices, underscores the incremental restoration of energy necessary for maintaining stamina in neurosurgery training. The DoT concept symbolizes the need to manage the often insidious and deleterious effects of chronic stress on residents' wellbeing. Discussion and conclusion These gaming concepts provide an integrative framework for understanding the challenges faced and strategies employed in neurosurgical residency. The interplay between resilience, wellness practices, and effective stress management, represented by DBNO, HoT, and DoT respectively, is critical for maintaining health and fostering professional excellence. By embedding these metaphors within the training paradigm, the neurosurgical residency journey can be navigated more effectively, promoting not only professional success but also personal growth and wellbeing.
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Affiliation(s)
- Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
| | - Anna C. Lawson McLean
- Department of Neurosurgery, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
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McCloskey K, Turlip R, Ahmad HS, Ghenbot YG, Chauhan D, Yoon JW. Virtual and Augmented Reality in Spine Surgery: A Systematic Review. World Neurosurg 2023; 173:96-107. [PMID: 36812986 DOI: 10.1016/j.wneu.2023.02.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Augmented reality (AR) and virtual reality (VR) implementation in spinal surgery has expanded rapidly over the past decade. This systematic review summarizes the use of AR/VR technology in surgical education, preoperative planning, and intraoperative guidance. METHODS A search query for AR/VR technology in spine surgery was conducted through PubMed, Embase, and Scopus. After exclusions, 48 studies were included. Included studies were then grouped into relevant subsections. Categorization into subsections yielded 12 surgical training studies, 5 preoperative planning, 24 intraoperative usage, and 10 radiation exposure. RESULTS VR-assisted training significantly reduced penetration rates or increased accuracy rates compared to lecture-based groups in 5 studies. Preoperative VR planning significantly influenced surgical recommendations and reduced radiation exposure, operating time, and estimated blood loss. For 3 patient studies, AR-assisted pedicle screw placement accuracy ranged from 95.77% to 100% using the Gertzbein grading scale. Head-mounted display was the most common interface used intraoperatively followed by AR microscope and projector. AR/VR also had applications in tumor resection, vertebroplasty, bone biopsy, and rod bending. Four studies reported significantly reduced radiation exposure in AR group compared to fluoroscopy group. CONCLUSIONS AR/VR technologies have the potential to usher in a paradigm shift in spine surgery. However, the current evidence indicates there is still a need for 1) defined quality and technical requirements for AR/VR devices, 2) more intraoperative studies that explore usage outside of pedicle screw placement, and 3) technological advancements to overcome registration errors via the development of an automatic registration method.
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Affiliation(s)
- Kyle McCloskey
- Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Ryan Turlip
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hasan S Ahmad
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yohannes G Ghenbot
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daksh Chauhan
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jang W Yoon
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Rony MKK, Md Numan S, Alamgir HM. The association between work-life imbalance, employees' unhappiness, works impacts on family, and family impacts on work among nurses: A Cross-sectional Study. INFORMATICS IN MEDICINE UNLOCKED 2023. [DOI: 10.1016/j.imu.2023.101226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Ujjan BU, Hussain F, Nathani KR, Farhad A, Chaurasia B. Factors associated with risk of burnout in neurosurgeons: current status and risk factors. Acta Neurol Belg 2022; 122:1163-1168. [PMID: 35988123 PMCID: PMC9392991 DOI: 10.1007/s13760-022-02072-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/15/2022] [Indexed: 12/03/2022]
Abstract
Objective The study aimed to evaluate burnout and associated risk factors in neurosurgical residents and faculty members. Summary of background data Burnout is an occupational risk of emotional exhaustion, depersonalization, and reduced perception of personal accomplishment secondary to work stress. It burdens the individual with immense mental stress causing compromised professional performance. Healthcare workers, particularly surgeons, have been documented to be at high risk of developing burnout, considering the stressful routine and serious impact of their profession. Methods The modified Maslach Burnout Inventory was filled by fellow neurosurgical residents or consultants. The respondents were classified into burnout and non-burnout groups and then analyzed for the associated risk factors. The data were analyzed using SPSS v26. Results One hundred and thirty-eight neurosurgical healthcare workers, including 62 residents and 76 consultants, responded to the questionnaire. The burnout and non-burnout groups comprised 83 (60%) and 55 (39.9%) respondents. Female gender and few kids were observed as significant risk factors for the development of burnout (p = 0.013 and p = 0.006, respectively). Regardless of its year, residency was a risk factor for overall burnout, as well as in each subsection of the Maslach Inventory (p = 0.002). In consultants, recent qualifications and a high number of weekly calls were also associated with a significant risk of burnout (p = 0.012 and p = 0 .027, respectively). Marital status and national economic status did not reveal any influence on the status of burnout in neurosurgical healthcare workers. Conclusion Burnout syndrome is a prevalent and serious, yet overlooked, condition among neurosurgeons. Adequate assessment and steps should be encouraged to ensure physician and patient safety.
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Affiliation(s)
- Badar Uddin Ujjan
- Department of Neurosurgery, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Farhad Hussain
- Department of Neurosurgery, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan.
| | - Karim Rizwan Nathani
- Department of Neurosurgery, Dow University of Health Sciences, Ojha Campus, Karachi, Pakistan
| | - Aisha Farhad
- Department of Internal Medicine, Liaquat National Hospital, Karachi, Pakistan
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Pandit AS, Reka A, Layard Horsfall H, Marcus HJ. Mindfulness Training for Young Neurosurgeons: A Virtual Multicenter Prospective Pilot Study. World Neurosurg 2022; 164:e446-e457. [PMID: 35533949 DOI: 10.1016/j.wneu.2022.04.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Burnout is prevalent among neurosurgeons and can negatively impact both technical and nontechnical skills and subsequent patient care. Mindfulness training has previously been shown to ameliorate the effects of burnout and improve performance in health care workers and high-stress occupations, but no such evaluation has been formally conducted for neurosurgeons. We aimed to determine the effectiveness and feasibility of a virtual mindfulness-based intervention (MBI) in neurosurgeons. METHODS A prospective trial of an MBI was implemented and hosted from our tertiary academic unit, running virtually from October to December 2020. Practicing neurosurgeons of all grades were recruited from 9 neurosurgical centers. Participants underwent 8 weeks of 90-minute MBI classes and suggested daily practice. Psychometric measures related to burnout, stress, wellbeing, and mindfulness competencies were assessed at baseline and on course completion. RESULTS Twenty-one neurosurgeons participated in the study (attendings = 2, residents = 18, interns = 1, mean age = 30.3 [standard deviation 3.9] years). Significant improvements after intervention were present in perceived stress (Z = -2.54, P = 0.04) and emotional exhaustion (Z = -2.41, P = 0.04). Mindfulness training was associated with improved mindfulness skills (Z = -2.58, P = 0.006), self-compassion (t = -4.4, P = 0.002), resilience (Z = -3.18, P = 0.004), and choice response times (Z = -2.13, P = 0.03). All neurosurgeons who completed the postintervention assessment stated they would recommend the course and agreed that it was relevant to their surgical practice. CONCLUSIONS Preliminary evidence from this trial cautiously supports the effectiveness and feasibility of a virtual MBI for dealing with stress, burnout, and improving dexterity among young neurosurgeons. Further research is warranted to validate these findings.
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Affiliation(s)
- Anand S Pandit
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Arisa Reka
- Department of Medicine, University College London, London, United Kingdom
| | - Hugo Layard Horsfall
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Hani J Marcus
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom
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Kelly PD, Yengo-Kahn AM, Roth SG, Zuckerman SL, Chitale RV, Wellons JC, Chambless LB. Data-Driven Residency Training: A Scoping Review of Educational Interventions for Neurosurgery Residency Programs. Neurosurgery 2021; 89:750-759. [PMID: 34423828 DOI: 10.1093/neuros/nyab322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/06/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Neurosurgery residency programs are tasked with imparting large volumes of both clinical knowledge and technical skill to trainees in limited time. Many investigators have described local practices, which may offer evidence-based interventions in neurosurgical residency education, but this literature has not been systematically reviewed. OBJECTIVE To perform a scoping review of educational practices in neurosurgery, which are supported by quantitative, peer-reviewed research. METHODS A scoping review of the literature was performed. PubMed, Embase, and Web of Science databases were queried for articles describing educational interventions for neurosurgery residents, which included a quantitative assessment of the effect on resident performance. RESULTS From an initial set of 1785 unique articles, 29 studies were ultimately screened and included. Studies were into the following 6 topics: (1) didactics and curricula (n = 13), (2) nontechnical skills (n = 6), (3) wellness and burnout (n = 4), (4) assessment and feedback (n = 2), (5) mentorship and career development (n = 2), and (6) research (n = 2). Individual study results were described. CONCLUSION Several educational interventions in neurosurgical training are supported by quantitative evidence. Methodological shortcomings are prevalent among studies of education, particularly in the selection of meaningful outcome measures. A summary of evidence-based considerations is provided for current and future program directors.
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Affiliation(s)
- Patrick D Kelly
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Aaron M Yengo-Kahn
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Steven G Roth
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Scott L Zuckerman
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rohan V Chitale
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John C Wellons
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lola B Chambless
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Team Sport Participation Protects Against Burnout During Neurosurgery Training: Cross-Sectional Survey Study. World Neurosurg 2021; 156:e104-e110. [PMID: 34506980 DOI: 10.1016/j.wneu.2021.08.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Burnout is experienced by up to two thirds of neurosurgery residents. Team sport participation as an adolescent protects against adverse mental health outcomes in adulthood. The objective of this study was to determine whether high school or collegiate team sport participation is associated with improved psychological well-being during neurosurgery residency. METHODS A cross-sectional survey study of U.S. neurosurgery residents was conducted between June 2020 and February 2021. Outcomes included self-ratings of sadness, anxiety, stress, burnout, optimism, and fulfillment, on 100-point scales, which were averaged into a "Burnout Composite Score" (BCS). Respondents were grouped and compared according to their prior self-reported participation in team sports (participants vs. nonparticipants). A 3-way analysis of variance tested the effects of resident level, exercise days, and team sport participation on BCS. RESULTS Of 229 submitted responses, 228 (99.5%) provided complete data and 185 (81.1%) residents participated in team sports. Days/week of exercise was similar across groups (2.5 ± 1.8 vs. 2.1 ± 1.8, P = 0.20). The team sport group reported lower mean BCS (37.1 vs. 43.6 P = 0.030, Cohen d = 0.369). There was a significant interaction between prior team sport participation and exercise regimen on BCS (F [3, 211] = 3.39, P = 0.019, n2 = 0.046), such that more exercise days per week was associated with decreased BCS for prior team sport athletes (F [3, 211] = 11.10, P < 0.0005), but not for nonparticipants (F [3, 211] = 0.476, P = 0.699). The positive impact of prior team sport participation was more pronounced for senior residents (-11.5 points, P = 0.016) than junior residents (-4.3 points, P = 0.29). CONCLUSIONS Prior team sport participation was associated with lower BCS among neurosurgery residents, an effect more pronounced during senior residency. Lessons imparted during early team sport experience may have profound impacts on reducing burnout throughout a 7-year neurosurgery residency.
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Burnout and Emotional Intelligence in Neurosurgical Advanced Practice Providers Across the United States: A Cross-Sectional Analysis. World Neurosurg 2021; 155:e335-e344. [PMID: 34425289 DOI: 10.1016/j.wneu.2021.08.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Although much research has examined nursing and physician burnout, the advanced practice provider (APP) population has not yet been studied. The goal of the present study was to survey APPs in neurosurgery to determine whether greater emotional intelligence (EI) is protective against burnout. METHODS An 80-item survey was created that incorporated the Maslach Burnout Inventory Human Services Survey for Medical Personnel, the Trait Emotional Intelligence Questionnaire-short form, and original questions developed by us. The collective survey was distributed, administered, and collected using the web-based REDCap (Research Electronic Data Capture) platform. Statistical analyses were completed using a comparison between participants with and without burnout. RESULTS A total of 106 neurosurgical APPs (26 men, 80 women) completed the survey, of whom, 57 (54%) reported current burnout. High average scores for personal accomplishment and global EI were inversely related to burnout (P = 0.034 and P = 0.003, respectively). In addition, the following factors were associated with burnout: inadequate support staff in the work place (P = 0.008), inadequate time off work (P < 0.001), inadequate administrative time (P = 0.009), not experiencing support from one's supervisor (P = 0.017), insufficient time for continuing medical education (P < 0.001), an inability to separate work from personal time (P < 0.001), and an inability to advance within one's professional field (P = 0.043). CONCLUSIONS For neurosurgical APPs, EI is protective against burnout. Many opportunities exist at the individual and organizational level to alleviate burnout among neurosurgical APPs. Targeted strategies to improve work-life balance, EI, support systems, and opportunities for career development among neurosurgical APPs might enhance employment satisfaction and reduce burnout.
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